While prepping a 67-year-old female patient for routine cataract surgery at England’s Solihull Hospital, physicians noticed a strange bluish blob in one of her eyes.
On closer look, the blob turned out to be 17 contact lenses stuck together. Another 10 lenses were subsequently discovered in the same eye. The surgeons have never seen anything quite like it.
As reported in the British Medical Journal, the unnamed patient was unaware that the contact lenses were missing. Incredibly, the 27 lost lenses, which had drifted behind her upper eyelid, weren’t causing her any serious distress. She figured her dry eyes and periodic discomfort were just a product of old age.
“None of us have ever seen this before,” noted surgeon Rupal Marjaria, who filed the BMJ report, in Optometry Today. “It was such a large mass. All the 17 contact lenses were stuck together. We were really surprised that the patient didn’t notice it because it would cause quite a lot of irritation while it was sitting there.”
The Solihull Hospital surgical team decided to postpone the cataract surgery due to the increased risk of endophthalmitis inflammation of the inner eye. This condition can lead to vision loss and even loss of the eye itself, and is a common complication of cataract surgeries. The surgeons were concerned that a build-up of bacteria in the clump might trigger it.
The patient had been using monthly disposable contact lenses for about 35 years, but hadn’t visited her optometrist in quite some time. What’s more, she didn’t mention any symptoms during her pre-operative assessment. Marjaria thought it important to write a case report about the incident, showing that it’s possible for a person to retain lots of contact lenses without experiencing too much discomfort.
“She was quite shocked,” Marjaria told Optometry Today. “When she was seen two weeks after I removed the lenses she said her eyes felt a lot more comfortable. She thought her previous discomfort was just part of old age and dry eye.”
This case is obviously extreme; most people experience significant discomfort and redness, as well as an increased risk for infections, when contacts get stuck in their eyes. It’s not immediately obvious why this patient was so asymptomatic, but it may have had something to do with her “deep set eyes,” according to the BMJ report.
Wearers of contact lenses know how frustrating and unsettling it can be to displace a lens. Here’s how you get a contact lens out from the top of your eye, according to the American Academy of Ophthalmology:
Surgeons have removed 27 contact lenses from the eye of a 67-year-old woman who had come to Solihull Hospital for routine cataract surgery.
"A bluish foreign body" turned out to be a "hard mass" of 17 lenses stuck together with mucus, and 10 more were then found under further examination. A report in the BMJ said she had worn disposable lenses for 35 years, and had not complained of any irritation. But after they were removed, she said her eyes felt a lot more comfortable.
'Shocked'
Specialist trainee in ophthalmology Rupal Morjaria told Optometry Today: "None of us have ever seen this before. "It was such a large mass. All the 17 contact lenses were stuck together.
"We were really surprised that the patient didn't notice it because it would cause quite a lot of irritation while it was sitting there."She was quite shocked. She thought her previous discomfort was just part of old age and dry eye."
'Hiding'
The case report said the patient had poorer vision in her right eye and deep-set eyes, which may have been a factor in the lenses becoming lost.
Association of Optometrists spokeswoman Ceri Smith-Jaynes said losing contact lenses in the eye was a common problem but they usually worked their way out. "They are normally hiding, folded up under the top lid of the eye," she said.
"They can't go any further up than that because there is a pocket. "It's the same under the bottom lid - the lens can only be in one of those places."
Top tips for contact lens wearers:
· Don't wear your lenses for longer than you have been told to, and not for more than 16 hours in a day - you should never sleep in them
· Wash and dry your hands before putting anything in your eye
· Never apply eye make-up before putting in contact lenses
· Replace your contact lens case regularly to reduce the risk of infection
· If you spot any signs of redness, pain or loss of vision, consult your optometrist or optician immediately
· Make sure you go for regular check-ups
· If in doubt, take them out
The first step is to be sure the contact lens is still on the eye. The contact lens can fall out of the eye and it may be assumed that it has merely moved under the eyelid. It is important to note also that the contact lens can only go as far as the crease in the conjunctiva under the upper eyelids and it cannot go behind your eye.
To remove the lens you should first wash your hand carefully and relax the eyelid and see if you can feel the lens through the eyelid. It may help to apply some sterile saline or artificial tears to help float the contact lens out from under the eyelid. If a corner of the lens can be visualized in a mirror you can use a finger to slide it back down over the cornea where it can be removed normally.
If the lens is suspected to be under the upper eyelid, it may also help to bring the lens in to view by looking downward as far as possible. Another technique is to gently massage through the eyelid down towards the cornea or you can try to lift or “flip” the eyelid to make the lens visible. Lastly, if you cannot retrieve the lens or if the eye is bothersome, you should call and schedule an appointment to see your ophthalmologist as soon as possible.
The last sentence is the critical one. If at any point you feel this is beyond your abilities, just go see your eye doctor. As this bizarre case study shows, don’t just leave it in there.
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